Purpose/Hypothesis : Reflection and narrative are important for clinical learning and their use continues to gain popularity for clinical learning experiences. Narrative reflection allows the telling of the story of a complex patient encounter, and then reflecting, analyzing, and evaluating the situation in preparation for improved patient-centered care. The integration of reflection in early physical therapist education is essential to the development of critical thinking and professional identity.The purpose of this study was to explore themes in reflective narratives written by student physical therapists during their initial clinical experiences, to examine levels of reflection present, and to assess levels of agreement and reliability of assessment of the levels of reflection.Number of Subjects : 20Materials/Methods : A retrospective analysis using both qualitative and quantitative methods was used to assess 20 student narratives that were written using a modified version of the Gibbs model as a guide. Data collection involved an iterative process of individual and cross narrative analyses. The framework of Hatton and Smith was used when determining the highest level of reflection achieved within the narrative. Percent agreement and CohenÕs weighted kappa were employed to assess the levels of agreement and reliability of assessment for the highest levels of reflection.Results : Five major themes were interpreted from the narratives including (1) patient-centered care, (2) professional role, (3) ethical issues, (4) critical thinking, and (5) student-clinical instructor relationship. All 20 narratives demonstrated some level of reflection with 85% demonstrating dialogic reflection. Initial percent agreement between all researchers was 68.57%.Conclusions : The incorporation of the Gibbs Model as a guide for the written narrative reflection aided the students to further develop reflective skills as compared with a previous study by Greenfield et al. The common themes found in this study and previous research have implications for the integration of reflective learning experiences early and throughout physical therapist curriculum to assist in student growth in these areas.Clinical Relevance : The results of this study can assist physical therapy educators to prepare their students on how to organize and write effective narratives to reflect on clinical experiences.. Thematic analysis provides students and educators insights into the types of issues and challenges embedded in early clinical experiences.